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Presented By Human Resources Department1

OE FAST FACTSNew Medical Insurance Provider andPersonalized Health & Benefits Support TeamOnline Access To Enroll via our NEW onlinesystem cfwbenefits.com Starts October 19Open Enrollment Deadline for ALL Plans isNovember 6, 2020, 11:59 pmChanges Are Effective January 1, 20212

CopaymentDeductibleA payment made by a beneficiary(especially for health services) in addition tothat made by an insurer.A specified amount of money that theinsured must pay before an insurancecompany will pay a claim.INSURANCETERMSCoinsuranceA type of insurance in which theinsured pays a share of the paymentmade against a claim.Total Out ofPocket MaximumThe most you have to pay for coveredservices in a plan year. After you spend thisamount on deductibles, copayments, andcoinsurance, your health plan pays 100% ofthe costs of covered benefits.

MEDICAL PLANOPTIONS FOR 2021Meritain Aetna –Choice Point of Service IIOpen Access Network4

An Aetna Company Processes claims Provides network Aetna Choice PointOf Service II OpenAccess Network(POS II)Health & BenefitsSupport TeamInsurance ProviderNEW! Medical Insurance Provider &Personalized Health & Benefits Support Enrollment support Find a provider Claims Questions Pharmacy Questions Logistics Care coordination5

Meritain Healthan Aetna CompanyWhen asked “who is your health insurancecarrier?” you reply:1. My coverage is through Meritain Health withAetna managing my provider network.2. Accolade is there to help you navigate thehealth care system and answer any questionsalong your journey.Here is how we partner for you

Begins when you receive your ID card in the mail it will include:Your HealthcareJourney1.The Aetna logo—Aetna manages your provider network2.Your company’s unique phone number and website for your Accolade Health Assistant by Accolade3.2And, the Meritain Health claim submission information13

AccoladeOur mission is toempower peoplethrough expertise,empathy, andtechnology to make thebest decisions for theirhealth andwell-being.Member.accolade.com

Meet the AccoladeHealth Assistantwork for City of Fort Worth employees and their family Wemembers — not the health plan Personalized experience: Yourown professional Health Assistant Identifying and removing barriers to care Total assistance at no additional costconfidential — information is not shared with Completelythe city.ErickaAccolade Health Assistantone number to call for health and health benefits Justquestions9

Claims & Billing QuestionsI thought this visit wascovered?Provider Option & Network StatusEligibility QuestionsCan I add my 24 yearold daughter to myinsurance plan?I’m not sure I like my doctor, can you helpme find one who understands me?Is there a better way to managemy stress?Can you help me understand what plan is bestfor me to enroll in?Health & Wellness ProgramsBenefits Questions

Connecting with Your Accolade Health Assistant is easy833-909-2353Call toll-free Monday through Friday,8:00 AM – 11:00 PM ESTNurses also available after hoursmember.accolade.comSend a secure message toyour Accolade Health Assistant or nurseAccolade mobile appDownload on the App Storeor Google PlayText PMC7 to 67793 to download the Accolade mobile app now!**Message and data charges may apply. Visit accolade.com for privacy policy.11

Same Two Plan Options For 2021Health Center Plan Free primary physician care Provides copays for specialists and prescriptiondrugs Maintains lower deductibles and out of pocketcosts Pediatrics, obstetrics and mental health servicescontinue with network physicians outside ofhealth centersConsumerChoice Plan High-deductible Health Savings Account (HSA) available to allowpeople to save for health costs on a pre-tax basis Members will be able to use the health centersat a discounted rateAll preventive care, including mammograms and colonoscopies, are free to members on both theHealth Center Plan and the Consumer Choice Plan12

HEALTH CENTERPLAN DETAILS(Free Primary Care)13

Advantages of Using the Health CentersEMPLOYEE HEALTH CENTERS establishedthroughTexas Health Resources (THR)All services at the health centersand satellite locations are FREESick visitsavailablechildren ages2 yrs old and upServices opento all coveredfamilymembersControlqualityof careUnlimitedHealth Centeroffice visitsHealth Center Plan: Three health centers supported by fivesatellite locations in the North Texas area All members seen same or next day for sickappointments in Health Centers locationsonly Staffed with quality doctors, physicianassistants and nurse practitioners No mandatory referrals required Appointments are scheduled, walk-ins or noshows are not acceptable14

Health Center EnhancementsDiabetesEducatorHormoneTherapyHelp manage diabetes byfocusing on 7 self care behaviors:For musculoskeletal conditions:1. Healthy eating2. Being active3. Monitoring4. Taking medication5. Problem solving6. Healthy copingStem Cell Therapy(Orthobiologics)Offered for both male and femalehormonesPlatelet-rich plasma and bonemarrow aspirate concentrateinjectionsEffective treatment for those whosuffer from chronic pain due toarthritis and musculoskeletaldisorders.7. Reducing risks15

Physician Network Primary Care (Family Medicine, Internists, OB/Gyn,Pediatricians) All Health Center services are FREE All other Primary Care Providers 60 co-pay Specialists (All other physicians) 75 co-pay Find a provider www.aetna.com Aetna Choice Point of Service II Open Access Network16

CONSUMER CHOICEPLAN DETAILS(HSA Tax Savings Benefit)17

Consumer Choice PlanPhysicians Network Full access to Aetna Choice Point of Service II Open Access Network No referrals needed for specialists Can still use the Health Center at a reduced costCo-pay/Co-insurance Deductible increased to 2,800 individual/ 5,400 family Out of pocket maximums remains at 6,550 individual/ 13,000 family Pharmacy – deductible, then 20% co-insurance up to Out-of-Pocket maximumContributions City contributes 540/ 1,000 Premiums lower than Health Center Plan18

Pre-tax dollars to pay for out-ofpocket health care expenses Health Savings AccountsYou own the accountNo documentation neededGrow your account throughinvestments Funds rollover fromyear to year Doubles as a retirement account Withdrawal funds without a penalty atage 65 for non-medical expenses (taxesapply)19

Convenient Care Clinic:Health Center Plan 30Consumer Choice Plan 20% after deductible2020 Summary of Medical Plan BenefitsPlan FeaturesHealth Center PlanConsumer Choice PlanAnnual Deductible· Individual 1,500 2,800Urgent Care:· Family 3,000 5,400Health Center Plan 75Total Out of Pocket Max – including deductibles, copays, coinsurance, prescriptionConsumer Choice Plan 20%deductible, prescription copaysafter deductible· Individual 6,000 6,550· Family 12,000 13,000Non-emergency use ofPhysician Office Visitemergency rooms will be:· PCP (At Health Center) 0 copay 60 per visitHealth Center Plan 60 copay20% after deductible 300 then 50% after deductible · PCP· OBGYN/Peds 60 copay20% after deductibleConsumer Choice Plan · Specialist 75 copay20% after deductible50% after deductibleEmergency Room visits – for 300 copay (waived if admitted) 20% after deductibleVirtual Visits are free on thetrue emergencies onlyHealth Center Plan and low costCovered 100% afterCovered 100%on the Consumer Choice Plan Surgeries through Surgery deductible20

PHARMACY PLANSame Provider OptumRx21

Pharmacy Benefits - OptumRxHealth CenterPlan 100 Deductible, thenCoinsurance Maintenance Medicationsthrough Walgreens (retail)or Select90 Program forMaintenance MedicationsConsumerChoice Plan Deductible, thenCoinsurance Medications throughWalgreens (retail) Select90 Program forMaintenanceMedicationsMail Order OptumRx Mail Order 90 day supply

Health CenterPharmacy PlanRetailMail Order/Select 90Generic20% coinsurance, 10 min/ 20 max20% coinsurance, 25 min/ 50 maxBrand Formulary20% coinsurance, 30 min/ 50 max20% coinsurance, 75 min/ 125 maxBrand Non-Formulary20% coinsurance, 50 min/ 70 max20% coinsurance, 125 min/ 175 maxSpecialty20% coinsurance, 200 max20% coinsurance, 200 max 100 deductible Maintenance medications still obtained through mail order or Walgreens23

VISION PLANEYEMED24

Exam 10 copayVision Plan Highlights Frames 130 frame allowance 20% discount over 130every 24 months Lenses – 20 copay for single, bifocal, trifocal and lenticular Various copays for progressive tiers Various copays for reflective coating Every 12 months Contacts 125 allowance 15% discount over 125 Every 12 months Rates range from 3.00 per check for individual to 8.82 percheck for family25

WELLNESS PROGRAMVirgin Pulse26

Wellness ProgramMain Program – Premium Incentive Complete a Member Health Assessment (MHA) questionnaireComplete the Tobacco Affidavit or Alternative (TOB)Obtain Annual Physical, and submit the Physician Screening Form (PSF) 0- 100/Month on PremiumPurpose of Program Know your numbers Have a relationship with a health care provider who knows you Better insure gaps in care are addressedGo to www.fortworthtexas.gov/wellness27

Weight Loss Management ProgramsPlease Note:Employees canonly enroll in oneof the weightloss programs ata timeWatch the Roundup for enrollmentdatesWeightwatchers reimaginedEnroll onlineLearn how to lose weight andimprove your health while eating thefoods you love. You don't have tostarve yourself or count calories tolose weight and keep it off forever.Easy online app allows you to track food,activity and weight anytime.Enroll online anytimeDatabase of online recipesWeight Watchers coach available 24/7Online community to provide support

SURGERYPLUS(Option for Non-Emergent Surgeries)29

Most Common ProceduresOver Hundreds of Non-Emergent Procedures are CoveredKnee:––––Knee ReplacementKnee Replacement RevisionKnee ArthroscopyACL/MCL/PCL RepairHip:–––Hip ReplacementHip Replacement RevisionHip ArthroscopyShoulder:––––Shoulder ReplacementShoulder ArthroscopyRotator Cuff RepairBicep Tendon RepairOthersBariatricHerniaHysterectomySpine:– Laminectomy / Laminotomy– 360 Spinal Fusion– Artificial DiskWrist & Elbow:–––––Elbow ReplacementElbow FusionWrist FusionWrist ReplacementCarpal Tunnel ReleaseGeneral Surgery:–––Gallbladder RemovalHernia RepairThyroidectomyGenitourinary:– Hysterectomy– Tubal Ligation– Bladder RepairFoot & Ankle:––––BunionectomyHammer Toe RepairAnkle ArthroscopyAnkle ReplacementTo learn more, call the City of Fort Worth’s dedicated line at1-855-200-9508 or visit cfw.surgeryplus.com30

DENTAL PLANSProvider Delta Dental31

DPPO PlanSimilarities You can use any Dentist in the US 50 deductible per person No referrals needed for specialtycare Balance bill exposure for servicesby out of network providers32

Delta Dental Benefits – DPPODental PPO (DPPO)DeductibleDDPO - Low Option*DPPO - High Option 50 per person/ 150 per family 50 per person/ 150 per familyAnnual MaximumProvider 1,000 per person 2,000 per personUnlimited - PPO Network availableUnlimited - PPO Network availablePreventive & Diagnostic CarePlan pays 100% with no deductiblePlan pays 100% with no deductibleBasic Restorative CarePlan pays 50%Plan pays 80%Major Restorative CarePlan pays 50%Plan pays 50%OrthodontiaPlan pays 50%Plan pays 50%*You may be balance billed for going to a non-Delta Dental PPO network dentist. You will be billed the difference between the PPO fee and the Delta Dental Premier dentist feeor the Out-of-Network dentist fee.33

DHMO PLAN No deductibles or calendar-yearmaximums Must use contracted Dentists &choose a PCD Pediatric dentist for children up toage 8 Orthodontic coverage is included foradults & children